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In Case You Missed It:

By the way, doctor: Should I get the shingles vaccine?

Q. I'm 79 and had chickenpox as a
child. Should I get the shingles vaccine? What are the risks?

A. The U.S. Advisory Committee on
Immunization Practices (ACIP) recommends the shingles vaccine for
most people ages 60 and over, regardless of whether they recall
having had the chickenpox or not. (Studies show that 99% of
people over age 40 have had chickenpox.) Shingles, also called
herpes zoster, or zoster, is a painful blistering rash caused by
the same virus that causes chickenpox — the varicella zoster
virus (VZV). After you recover from chickenpox, VZV retreats to
nerve cells near the spine, where it lies dormant until it comes
to life again as shingles. About one in three people will develop
shingles during her or his lifetime. It occurs most often in
older adults and in people whose immune systems have been
weakened by chronic infections, cancer, or immune-suppressing
drugs, such as steroids or chemotherapy.

When VZV is reactivated, it moves away from the spine and travels
along nerve pathways that provide the sensory network for
specific skin areas called dermatomes, which are arranged in a
band-like pattern radiating from the spine. The shingles rash —
small fluid-filled blisters resembling chickenpox — breaks out
along dermatome lines on one side of the face or body (see the
illustration). It can range from simply itchy and uncomfortable
to extremely painful, and it may be accompanied by fever,
headache, and nausea. The rash crusts over after seven to 10
days, and is usually gone within a few weeks. In about 20% of
cases, the pain lingers after the rash has disappeared; this
sometimes debilitating condition is called postherpetic
neuralgia.